WASHINGTON — John Haaga, a senior official at the National Institute on Aging, offers a disquieting thought for baby boomers heading into their later years.

“The best advice we can give people for old age is ‘Take a lot of long walks and have a lot of daughters and daughters-in-law.’”

Unless a retiring couple has hundreds of thousands of dollars saved for health care, exercise and family caregivers could be vitally important.

A new report from the Institute on Aging, “65+ in the United States: 2010” (census. gov/content/dam/Census/library/publications/2014/demo/p23-212.pdf), estimates a couple retiring in 2010 needed $190,000 for out-of-pocket care. If one of them needs nursing home care, it took $260,000 in savings. This is money required to pay bills that exceed the health coverage of Medicare.

Many Americans heading into old age don’t have that kind of money.

Health care costs, Haaga said, are “still growing at a rate — along with the old-age population — that makes it pretty hard to see what else the federal government can spend money on.”

“And the big sleeper issue is long-term care costs,” he added. “Most people in the baby boom generation don’t realize what they’re on the hook for.”

In Texas, nursing home care is relatively inexpensive. But a recent report from AARP’s Public Policy Institute (long termscorecard.org) suggests you don’t want to be there.

Nearly half the staff at Texas nursing homes leaves every year, and 15.6 percent of those are fired. The quality of care and the quality of life in Texas nursing homes ranks 49th out of the 50 states, according to AARP’s report.

Texas nursing homes are at the very bottom when it comes to administering anti-psychotic drugs to their residents.

“It’s not appropriate when given to people who don’t have schizophrenia or bipolar disorder,” said Susan Reinhard, senior vice president with AARP’s Public Policy Institute. “It’s known as a chemical restraint. What you’re viewing there could be seriously overmedicated people. This should be a huge red flag for Texas.”

Ninety percent of the long-term care in this country is delivered, unpaid, by family, mostly women. As the baby boom generation retires, though, this is changing. About 40 percent of the primary caregivers are now men, Reinhard said.

The number of family members — a spouse, children — able to support a disabled senior is dropping. Right now, there are seven potential caregivers for every senior. By 2050, there will only be two potential caregivers.

That’s the demographic picture that results from fewer children. The Institute on Aging’s report adds another aspect to the decline in potential caregivers: More baby boomers are divorced.

Haaga said this predicament cries out for insurance, but government and market efforts haven’t worked.

“It’s very hard to do it and to charge a premium that doesn’t cause people to gag and drop out,” he said. “We haven’t solved the problem. People are in greater danger than they realize of bankrupting themselves in old age.”

The Institute on Aging’s report shies away from policy recommendations. But what comes through is straightforward enough: Boomers should exercise. They should do what they can to avoid diabetes, high blood pressure and obesity. They should save more while they can.